Recommendations of the schizophrenia expert center network for the screening prevention and treatment of sleep disorders based on the results from the real-world schizophrenia FACE-SZ national cohort.

Abstract

BACKGROUND:

Sleep disorders associated factors are under explored in schizophrenia while the literature suggests high and heterogeneous frequency.

AIMS:

The objective of the present study was to determine the prevalence and risk factors of sleep disorders in the real-world FACE-SZ national cohort.

METHOD:

Stabilized schizophrenic outpatients were recruited in 10 expert centers for schizophrenia. Sleep quality was explored with the Pittsburgh Sleep Quality Index (PSQI) and sleep disorders was defined by a PSQI score > 5. Psychosis severity was measured with the Positive and Negative Syndrome Scale, current major depressive episode with the Calgary Depression Scale for Schizophrenia, verbal aggressiveness with the Buss-Perry Aggression Questionnaire, adherence to treatment with the Medication Adherence Rating Scale, akathisia with the Barnes Akathisia Scale. Current somatic comorbidities and body mass index were reported. Variables with P values <0.20 in univariate analysis were included in a multivariate regression model.

RESULTS:

Of the 562 included patients, 327 subjects (58.2%, IC95% [54.1% - 62.3%]) reported having sleep disorders. After adjustment, sleep disorders were significantly associated with migraine (adjusted odds ratio aOR = 2.23, p = 0.041), major depressive disorder (aOR 1.79, p = 0.030), poor adherence to treatment (aOR = 0.87, p = 0.006), akathisia (aOR = 1.29, p = 0.042) and verbal aggressiveness (aOR = 1.09, p = 0.002).

CONCLUSIONS:

More than one on two stabilized real-life outpatients with schizophrenia have been identified with sleep disorders. Combined with the literature data, we have yielded expert recommendations for the treatment and prevention of sleep disorders including treating undiagnosed comorbid depression and migraine and managing antipsychotic treatment to improve adherence and akathisia.

• Authors: P L Sunhary de Verville, D Etchecopar-Etchart, R Richieri, O Godin, F Schürhoff, F Berna, B Aouizerate, D Capdevielle, I Chereau, T D'Amato, C Dubertret, J Dubreucq, S Leignier, J Mallet, D Misdrahi, C Passerieux, B Pignon, R Rey, M Urbach, P Vidailhet, M Leboyer, P M Llorca, C Lançon, L Boyer, G Fond, FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group
• Journal: Progress in neuro-psychopharmacology & biological psychiatry (Prog Neuropsychopharmacol Biol Psychiatry) Vol. 110 Pg. 110275 (08 30 2021) ISSN: 1878-4216 [Electronic] England
• PMID: 33582207 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• Adult
• Brief Psychiatric Rating Scale
• Cohort Studies
• Depressive Disorder, Major (psychology)
• Expert Testimony
• Female
• Humans
• Male
• Mass Screening
• Psychotic Disorders (complications)
• Schizophrenia (complications)
• Schizophrenic Psychology
• Sleep Quality
• Sleep Wake Disorders (epidemiology, prevention & control)
• Surveys and Questionnaires